Date sent: Mon, 29 Apr 1996 02:57:14 -0400 Mike Ailed PRINCIPLES OF ABNORMAL PSYCHOLOGY Professor Leaf 05 October 1995 ESSAY ONE INTRODUCTION I. HISTORY OF THE PROBLEM The mystery of schizophrenia. Why does the disease happen? Who does it happen to? Where is the cause? What is its genesis? And more specifically, what is the intrinsic nature of this madness? Questions like these have been raised by doctors and shamans alike for nearly two centuries now, and, as of yet, not one among the scientific community at large, or in the past, has produced any definite universal answer, solution,or cure, only vast quantities of indefinite research, a fat bog of statistical data for the medical establishment(and the naive student) to delve and sink into. The search for a remedy. Where shall we start? In the beginning, of course, to carefully trace the past courses of examination concerning schizophrenia by the various researchers and authorities on the subject. Perhaps then we can learn from those attempts for a 'cure' and their subsequent 'failings' and become the wiser insofar as obtaining some type of knowledge, however limited, in knowing what to avoid in the future in order to treat the victims of this bewildering, mysterious condition. There is a good possibility that we might never per se find one ultimate definitive solution to this medical dilemma, but maybe we can come to terms with the disease of schizophrenia and cope with it by fashioning some sort of moderate resolution. Since the age of the Greeks, madness, i.e. insanity, has always had an established history in Western civilization. And rightly so. It's the one thing which classic society had to take a stand against, for its own survival depended on the affront. Governments are empowered by the people in the quest for human order. Madness, of course, stands in direct opposition to this organization. People often fear what they do not know of. Consequently, the insane were brushed under the rug and shipped to 'bins' which resembled, for all intents and purposes, the dungeon-prison. In the past, these 'defective' were forced to live in squalor, in chains, in the most deplorable conditions with no chance of ever seeing the outside world again. This was one of 'Western' society's cruel secrets, just one of a few(racism being one of them for example) where the old European- man had to suppress that which was in contrast to his status-quo. But this wasn't the case all over the globe. In fact, in North America, the early tribe inhabitants considered the lunatic as a person of poetic vision and prophecy. There the 'lunatic' was not reviled, but revered. Now I'm not trying to praise and promulgate the social protocol of the 'natural man' - at his finest. I'm only attempting to make the point that insanity is a specific Western notion. It can be only understood and realized in terms of the Western individual in the Western world. For if we knock away the surrounding walls of authority and order, insanity tends to be something more along the lines of a simple behavioral tendency, no different than the rest, as the mark of Nietzsche may attest. II. GOALS OF THE PRESENT STUDY Schizophrenia is a unique form of madness insofar as its time of entry into the course of European history. Below marks the indelible evidence which demonstrates its rise and prominence in society. FIGURE ONE 640 - * 625 - * avg. rate per million 525 - * 510 - * 500 - 450 - * 400 - * | | | | | | 1860 1870 1880 1890 1900 1910 year of admission *FIGURE 1. Insane asylum admission rates per one million population in England and Wales for the period 1859 to 1914. **[Adapted from Gottesman's adaption of Hare, p.3] As anyone can see, the rise in admissions was unprecedented. Schizophrenia was most definitely responsible for this onset and the surge of insanity among the population, here being in London and Wales. The symptoms as noted by puzzled doctors were various and "writers in Europe did report an alarming, acute increase of unmanageable insanity in their societies." Was the society to blame as the source of this functional psychosis? Gottesman examines this theory as "a tendency toward this kind of mental breakdown may have always been present in humans[i.e. a propensity], but emerged as an incapacitating illness only under the stress of losing personal space in increasingly urbanized and industrialized societies." Gottesman also projects the theory that schizophrenia was a new disease, perhaps the result of "a mutated bacterium that appeared in France soon after the Napoleonic wars and spread throughout the West." Another possibility also cited causally is the breakdown of cultural traditions and the family unit, but this is, for all intents and purposes, only a consequent of the presence of an industrial society in the life of modern-man. Therefore, it is most probable the "assembly-line" society that mankind has created for himself stimulated the disease of schizophrenia among the populace who had a biological predisposition towards it. Perhaps, this predisposition is within all of us and under certain key environmental factors we are provoked and forced into the condition. This dichotomy of the mental and the physical seem to be the mystery behind the disease. If we could find the key- elements, the internal-external combination which forces the disease from the recesses of the mind into the forefront of the personality, then - maybe - we might have something on the nature of the beast. METHOD The method of choice is psychoanalysis. The only way possible for an individual to overcome schizophrenia is by enolization. One-on-one examinations of the individual's personality should be made by a specialist. Only a carefully examined account of the mental and physical health history of the patient can give us the answers we need in order to determine if the patient can function within the guidelines of society's norms, i.e. Law. But should we just permit the dysfunctional to roam about the masses? Is there the possibility that the schIzophrenic are going to cause harm to the other 'healthy' members of society? The answer tends to be 'not really'(that is colloquially). Research data out of London from Eve Johnstone and colleagues has "provided unbiased information about the disturbed behaviors of 253 schizophrenics who met the criteria of the WHO studies." As noted by Gottesman, although six percent had threatened the people's lives(and a further thirteen percent had on one or two separate occasions), none had murdered. A twenty-two percent patient total had been involved with the law prior, but only for extremely bizarre anti-social behavior which was in no way endangering the well-being of the general population. As to the question of a cure. Do we really need one? Is the problem of schizophrenia a problem for the individual or is it just a problem for the society which surrounds the schizophrenic individual? The answer might be the latter. Now I'm not affirming that someone who is 'deranged' is enlightened and should do whatever he wants to. The thing that we have to provide to the patient is comfort. He has to learn coping mechanisms in order to function in the everyday world. We should not force a change in the patient's personality which confronts and conflicts with his individuality. In the past, with the advent of such harmful measures which all claimed to be the 'wonder cure', like the sedative drugs of the 1950's, or more bluntly and to the point, the lobotomy and electric shock therapy, have been used by specialists in the hope of improving the patient's lifestyle yet to no avail. The results have often been dreadful(we know all to well of what happened to Caroline Kennedy and the Jack Nicholson character in "One Flew Over the Cuckoo's Nest"). The civil liberty of the individual must be paramount. What boggles my mind is the necessity of the majority to make everything different the same, in of all places, a democracy. The condition of schizophrenia symptoms are for the most part as follows: "The Schizophrenic Five" 1. hallucinations 2. indifference 3. withdrawal from others, i.e. 'excessive' individuality(hereby known as "The Steppenwolf Syndrome") 4. hearing voices 5. delusional states(of both omnipotence and grandeur) As a simple reading of the above can attest, the only possible threat the schizophrenia can pose is one to himself. Nothing more. It is not a societal concern - nor an institutional one. Foremost, the schizophrenia should not be placed into some bureaucratically-run institution. Don't ever let the white walls and the linoleum floors in those places fool you. This 'dignified' asylum concept of Dorothea Dix is a proven failure(as the in-class documentary so vividly pictured) and is in principle no better than the prison-dungeon 'hospital' of long past. Scizophrenes are shipped there because the bourgeoisie couldn't stand the condition(a case can be made that this procedure is a in fact a subtle form of eugenics). For all intents and purposes, they wanted to get rid of what they viewed as a 'problem' as soon as possible. And the asylum was the medical establishment's quick-fix solution for the public's uneasiness about insanity in general. There they pumped pills(another quick-fix solution) and electrocuted their victims... patients, maintaining them like animals in a zoo. DISCUSSION We know very little about schizophrenia insofar as some universal Aristotelian definition or outline. I can think of nothing other than an analyst for the treatment of the schizophrenia. Research is doomed to fail, no matter how temporally extended it is or how solid the control of procedure. There are no symptomatic treatments for the patients. We cannot give them an aspirin and the fever will go away. The condition of schizophrenia is more along the lines of problems like obesity or the common cold. We all have a tendency to gain weight or get a cold if we are interacting in a conflicting manner with outside elements. The human body has such biological propensities as defensive mechanisms. The symptoms are reactions to an unhealthy environment or way of life brought about by outside elements that man might not be able to handle, neither psychologically or mentally. But just as the human has the propensity for schizophrenia, it also has the propensity of getting rid of it, or at least, putting into submission. This resolution could hopefully be attained by a change of environment and an examination of that patients particular symptoms of psychosis. And the specialists must focus on the particulars. It doesn't make sense to treat every patient alike. The only way we could take this universal course is if schizophrenia had a scientific basis, some sort of genetic link. BIBLIOGRAPHY 1. Gottesman, Irving I., W.H. Freeman and Company, c. 1991.